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Patients and physicians have concerns about current gMG management1

84% of patients with generalized myasthenia gravis (gMG) and all of the physicians sampled in a recently published survey raised concerns about long-term side effects of immunosuppressive therapy.1*

The majority of both groups also expressed concerns about the potential implications of a dose reduction, such as symptomatic relapse, possible hospitalization, and uncertainty about their future health.1

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Results were based on a peer-reviewed study of 283 patients with gMG and 45 physicians. The goal of the surveys was to better define patient and physician opinions about gMG long-term immunosuppressant exposure and dose reduction to inform the potential design of a randomized clinical trial.

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gMG impacts patients' physical and psychological well-being2,3

Patients with gMG often struggle with activities of daily living because of incomplete symptom control.2

Lungs

Myasthenic crisis can occur in up to 20% of patients, which can cause fatal respiratory failure, often requiring mechanical ventilation.4,5

Mirror Description

Patients may refuse therapy or not be adherent to avoid changes in physical appearance (eg, weight gain, bloating, acne).6,7

Infection

The long-term treatment risks may include liver and kidney toxicity, leukopenia, malignancies, and infections.7-10

Brain

Symptoms can make socializing difficult and increase feelings of anxiety and isolation.2,6,11

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There is much work to be done in gMG

The management of gMG varies considerably, with physicians often making treatment decisions based on experience12,13:
   

  • gMG is heterogeneous and requires individualized treatment approaches14
    – According to current gMG guidelines, there is widespread agreement on the use of many different treatments for gMG, but there is no one accepted standard of care14
  • Patients with autoantibodies against acetylcholine receptors (AChR), muscle-specific tyrosine kinase (MuSK), and low-density lipoprotein receptor-related protein 4 (LRP4) and patients that are seronegative for pathogenic autoantibodies may respond differently to available treatments8,10,14
  • Many patients respond well to current treatments, but it may take months to see results8,10
    – There are some patients who do not find any symptomatic relief with current treatments8,10

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References: 1. Hehir MK et al. Muscle Nerve. 2020;61(6):767-772. doi:10.1002/mus.26850 2. Twork S et al. Health Qual Life Outcomes. 2010;8:129. doi:10.1186/1477-7525-8-129 3. Boldingh MI et al. Health Qual Life Outcomes. 2015;13:115. doi:10.1186/s12955-015-0298-1 4. Grob D et al. Muscle Nerve. 2008;37(2):141-149. doi:10.1002/mus.20950 5. Wendell LC, Levine JM. Neurohospitalist. 2011;1(1):16-22. doi:10.1177/1941875210382918 6. Howard JF. Myasthenia Gravis: A Manual for the Health Care Provider. Myasthenia Gravis Foundation of America; 2009. 7. Liu D et al. Allergy Asthma Clin Immunol. 2013;9(1):30. doi:10.1186/1710-1492-9-30 8. Gotterer L, Li Y. J Neurol Sci. 2016;369:294-302. doi:10.1016/j.jns.2016.08.057 9. Guo Y et al. Front Immunol. 2018;9:1299. doi:10.3389/fimmu.2018.01299 10. Gilhus NE et al. Nat Rev Dis Primers. 2019;5(1):30. doi:10.1038/s41572-019-0079-y 11. Suzuki Y et al. BMJ Open. 2011;1(2):e000313. doi:10.1136/bmjopen-2011-000313 12. Sieb JP. Clin Exp Immunol. 2014;175(3):408-418. doi:10.1111/cei.12217 13. Sussman J et al. Ann N Y Acad Sci. 2018;1412(1):166-169. doi:10.1111/nyas.13503 14. Sanders DB et al. Neurology. 2016;87(4):419-425. doi:10.1212/WNL.0000000000002790

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